MUNICIPAL REGULATIONS for NURSE PRACTITIONERS

MUNICIPAL REGULATIONS for NURSE PRACTITIONERS

CHAPTER 59 NURSE-PRACTITIONERS Secs. 5900 Applicability 5901 General Requirements 5902 Term of Certificate 5903 Renewal of Certificate 5904 Educational Requirements 5905 National Examination 5906 Certification by Endorsement 5907 Standards of Conduct 5908 Scope of Practice 5909 Prescriptive Authority 5910 Prescribing Controlled Substances 5911 [Repealed] 5912 Use of Titles or Abbreviations 5913 Practice Of A Certified Registered Nurse-Practitioner In Health Care Facilities Requiring A Formal Evaluation 5914 Supervised Practice of Students 5915 Supervised Practice of Graduates 5916 Supervised Practice of Applicants for Certification by Endorsement 5999 Definitions 5900 APPLICABILITY 5900.1 This chapter shall apply to applicants for and holders of a certificate to practice as nurse-practitioners. 5900.2 Chapters 40 (Health Occupations: General Rules) 41 (Health Occupations: Administrative Procedures), and 54 (Registered Nursing) of this title shall supplement this chapter. 5901 GENERAL REQUIREMENTS 5901.1 Only a person currently licensed, as a registered nurse under Chapter 54 of this title shall be eligible to apply for a certificate to practice as a nurse-practitioner under this chapter. 5902 TERM OF CERTIFICATE 5902.1 Subject to 5902.2, a certificate issued pursuant to this chapter shall expire at 12:00 midnight of June 30 of each even-numbered year. 5902.2 If the Director changes the renewal system pursuant to 4006.32 of chapter 40 of this title, a certificate issued pursuant to this chapter shall expire at 12:00 midnight of the last day of the month of the birthdate of the holder of the certificate, or other date established by the Director.

5903 RENEWAL OF CERTIFICATE 5903.1 A holder of a certificate to practice as a nurse-practitioner shall renew his or her certificate by submitting a completed application on the forms required by the Board and paying the required fees prior to the expiration of the certificate. 5903.2 The Board s staff shall mail out applications for renewal at least sixty (60) days prior to the date the certificate expires. 5903.3 A certificate holder shall have the burden of notifying the Board if a renewal notice is not received. 5903.4 A certificate holder shall notify the Board in writing of a change in home or business address within thirty (30) days after the change.. 5903.5 A certificate holder applying for renewal of a certificate to practice as a nursepractitioner shall: (a) Maintain current licensure as a registered nurse in the District of Columbia; (b) Submit evidence of current national certification or recertification, as Applicable, by the American Nurses Credentialing Center (ANCC) or other national certifying body approved by the board; and (c) Beginning with the 2006 renewal period, submit proof of completion of fifteen (15) contact hours of continuing education, which shall include a pharmacology component. A continuing education program, course, seminar, or workshop shall be approved by the ANCC or other nationally certifying organization recognized by the Board and shall be related to the certificate holder s specialty. Only continuing education hours obtained in the two (2) years immediately preceding the application date will be accepted. 5903.6 A certificate holder shall submit a verification form of completion, for each program, course, seminar, or workshop for which continuing education is claimed. 5903.7 A certificate holder applying for renewal of a certificate who fails to submit proof of having completed the requirements as set forth in 5903.5 by the date the certificate expires may renew the certificate within sixty (60) days after the expiration by submitting the required documents and paying the required late fees. 5903.8 Upon submitting the required documents and paying the required late fees, the certificate holder shall be deemed to have possessed a valid certificate during the period between the expiration of the certificate and the submission of the required documents and fees.

5903.9 If a certificate holder applying for renewal of a certificate fails to submit proof of completion of the requirements as set forth in 5903.5 or pay the late fee within sixty (60) days after the expiration of the certificate holder s certificate, the certificate shall be considered to have lapsed on the date of expiration and the certificate holder shall thereafter be required to apply for reinstatement of an expired certificate and meet all requirements and fees for reinstatement. 5903.10 The Board may, in its discretion, grant an extension of the sixty (60) day period to renew the certificate after expiration, if the certificate holder s failure to submit proof of the requirements or pay the late fee was for good cause. As used in this section good cause includes the following: (a) Serious and protracted illness of the certificate holder; and (b) The death or serious and protracted illness of a member of the certificate holder s immediate family. 5904 EDUCATIONAL REQUIREMENTS 5904.1 An applicant for a license to practice as a nurse-practitioner shall furnish proof satisfactory to the Board, in accordance with 608(c) of the Act, D.C. Official Code 3-1206.08, that the applicant has successfully completed a post-basic nursing eduction program applicable to the area of practice approved by the Board or accredited by a nationally recognized body accepted by the Board and which is relevant to the nurse-practitioner s area of practice. 5904.2 [REPEALED] 5904.3 [REPEALED] 5904.4 [REPEALED] 5905 NATIONAL EXAMINATION 5905.1 In addition to the requirements in 5901 and 5904, to qualify for a certificate to practice as a nurse practitioner in the District of Columbia, an applicant shall receive a passing score on the national certification examination by the American Nurses Credentialing Center (ANCC) or any other nationally recognized certifying body accepted by the Board. 5905.2 An applicant shall submit proof of having obtained a passing score on the examination by arranging to have official written verification of the certification, or a certified notarized copy of the examination results, sent directly to the Board.

5905.3 A national certification program acceptable to the Board shall provide: (a) A scope of practice statement that reflects the standards of specialized and advanced nursing practice in the area of certification; (b) An approval process for the formal programs of study in the area of certification which shall: (1) Be based on measurable objectives that relate directly to the scope of practice; (2) Include theoretical and clinical content directed to the objectives; and (3) Be equivalent to at least one academic year preceptorship which is part of the formal program and shall be included as part of the academic year. Current practice in the area of certification will not be accepted as a substitute for the formal program of the study. (c) An examination in the area of certification which shall: (1) Measure the theoretical and clinical content denoted in the scope of practice; (2) Be developed in accordance with generally accepted standards of validity and reliability; and (3) Be open only to registered nurses who have successfully completed the program of study referred to in paragraph (b) of this subsection. (d) A certification maintenance program. 5905.4 The passing score on the certification examination shall be the passing score established by the certifying body administering the examination. 5905.5 The Board shall issue and update a list of nationally recognized certifying bodies accepted by the Board. 5905.6 Failure to maintain recertification as a nurse-practitioner shall result in the loss of status as a nurse-practitioner. 5906 CERTIFICATION BY ENDORSEMENT 5906.1 An applicant is eligible for certification by endorsement if the applicant is currently licensed or certified, in good standing, as a nurse practitioner under the laws of a state or territory of the United States.

5906.2 To apply for certification by endorsement, an applicant shall: (a) Submit a completed application on the forms required by the Board; (b) Submit a copy of his or her current license or certificate as a nurse practitioner with the application; (c) Obtain licensure or certification verification from the current state or territory of licensure or certification, that the license or certificate is current and in good standing. The verification form must be sent directly to the Board by the verifying Board; (d) Meet any other requirements as set forth by the Board; and (e) Pay all required fees. 5906.3 An application that remains incomplete for ninety (90) days or more from the date of submission shall be considered abandoned, and closed by the Board. The applicant shall thereafter be required to reapply, submit the required documents and completed forms, and pay the required fees. 5906.4 Nothing in this section shall be construed to prohibit the Board from utilizing other authorized databases to verify current licensure standing in other jurisdictions of the U.S. and to review disciplinary records. 5907 STANDARDS OF CONDUCT 5907.1 A nurse practitioner shall adhere to the standards set forth in the American Nurses Association s Code of Ethics as they may be amended or republished from time to time. 5908 SCOPE OF PRACTICE 5908.1 A nurse practitioner shall practice in accordance with 604 and 606 of the Act, D.C. Code 2-3306.4 and 2-3306.7 (1988). 5908.2 [Repealed] 5908.3 [Repealed] 5909 PRESCRIPTIVE AUTHORITY 5909.1 A nurse practitioner shall have authority to prescribe legend drugs and controlled substances subject to the limitations set forth in 5910.

5909.2 A nurse practitioner shall have authority to prescribe drugs only while certified in accordance with this chapter. 5909.3 Prescriptions for drugs shall comply with all applicable District of Columbia and federal laws. 5909.4 A nurse practitioner who administers or prescribes a prescription drug shall enter in the patient s chart on the date of the transaction or, if the chart is not available, no later than the next office day, the following information: (a) Each prescription that a nurse-practitioner orders; and (b) The name, strength, and amount of each drug that a nurse practitioner administers. 5909.5 Pursuant to 514 of the Act, D.C. Official Code 3-1205.14(a)(19), the Board may suspend or revoke the license or take other disciplinary action against any applicant or licensee who prescribes, dispenses, or administers drugs when not authorized to do so. 5910 PRESCRIBING CONTROLLED SUBSTANCES 5910.1 A nurse-practitioner shall have authority to prescribe those drugs on Schedules II through V established pursuant to the District of Columbia Uniform Controlled Substances Act of 1981, D.C. Code 33-501 et seq., that are authorized by the protocol under which the nurse-practitioner is practicing. 5910.2 A nurse practitioner shall not prescribe a controlled substance unless a licensed, certified nurse practitioner meets the following requirements: (a) Possesses a valid controlled substances certificate of registration from the United States Drug Enforcement Administration (DEA); and (b) Possesses a valid District of Columbia controlled substances registration pursuant to D.C. Official Code 48-901.02 et seq., the District of Columbia Uniform Controlled Substances Act. 5910.3 A nurse practitioner shall not issue a refillable prescription for a controlled substance. 5910.4 A nurse practitioner shall maintain a current and complete log of all controlled substances that the nurse practitioner prescribes in accordance with regulations for record keeping promulgated by the United States Drug Enforcement Administration. 5911 [REPEALED] 5912 USE OF TITLES OR ABBREVIATIONS

5912.1 Only a person certified by the Board to practice as a nurse practitioner may use the title or abbreviation Nurse-Practitioner, Certified Nurse-Practitioner, or C.N.P.. 5912.2 A nurse-practitioner may place the titles or abbreviations in 5912.1 after his or her name, alone or in combination with other letters or words identifying categories of specialization, including, but not limited to, the following: (a) Adult-Nurse Practitioner; (b) Pediatric Nurse-Practitioner (c) Family Nurses-Practitioner (d) Gerontologic Nurse-Practitioner (e) Neonatal Nurse-Practitioner; and (f) School Nurse-Practitioner (g) Psychiatric Nurse-Practitioner 5912.3 A specialty area of nursing practice shall be declared, and the specialty title to be utilized shall be the title which is granted by a nationally recognized accrediting body or the title of the specialty area of nursing practice in which the nurse practitioner has received postgraduate educational preparation. 5913 PRACTICE OF A CERTIFIED REGISTERED NURSE-PRACTITIONER IN HEALTH CARE FACILITIES REQUIRING A FORMAL EVALUATION 5913.1 An APRN shall be evaluated by another APRN licensed to practice in the same specialty area. 5914 SUPERVISED PRACTICE OF STUDENTS 5914.1 A student may practice as a nurse practitioner only in accordance with the Act and this chapter. 5914.2 A student fulfilling education requirements for certification and practicing within the limitations set forth in 103(c) of the Act, D.C. Official Code 3-1201.03(c), may be authorized to engage in the supervised practice as a nurse practitioner without a District of Columbia certificate.

5914.3 A person who has been denied a certificate, denied a license, disciplined, convicted of an offense that bears directly upon his or her fitness to be licensed, or who has such an action pending in the District of Columbia or another jurisdiction shall not practice pursuant to this section unless first authorized by the Board in writing. 5914.4 Only a nurse practitioner certified under the Act, who is an appointed faculty member of the accredited school or college, or a preceptor meeting the requirements set forth in chapter 56 of this Title, shall be authorized to supervise the practice of a student. 5914.5 A student who practices pursuant to this section shall only practice at a hospital, long-term care facility, a health facility operated by the District or the federal government, or other health care facility considered appropriate by the ANCC or other certifying body approved by the Board. 5914.6 All supervised practice of a student shall take place under general or immediate supervision. 5914.7 A student under this section shall not assume administrative or technical responsibility for the operation of a nurse practitioner program, unit, service or institution. 5914.8 A student shall identify himself or herself as such before practicing as a nurse practitioner. A student shall wear a picture identification badge with lettering clearly visible to the client bearing the name of the student and the position title. 5914.9 A student shall not receive compensation of any nature, directly or indirectly, from a client or client s family member. 5914.10 The appointed supervising faculty member shall be fully responsible for the practice by a student during the period of supervision and may be subject to disciplinary action for violations of the Act or this chapter by the student. 5914.11 The Board may deny an application for certification by, or take other disciplinary action against, a student who is found to have violated the Act or this chapter. The Board may, in addition to any other disciplinary actions permitted by the Act, revoke, suspend, or restrict the privilege of the student of practice. 5915 SUPERVISED PRACTICE OF GRADUATES 5915.1 A graduate may practice as a nurse practitioner only in accordance with the Act and this chapter.

5915.2 An individual may be authorized to engage in the supervised practice as a nurse practitioner as a graduate nurse practitioner, without a District of Columbia certificate if the individual: (a) Graduated from a post-basic nursing education program for nurse practitioners approved by the ANCC or other certifying body approved by the board; (b) Is awaiting the results of the certification examination given by the ANCC or other certifying body approved by the board; and (c) Has an initial application pending for certification to practice nurse-midwifery in the District of Columbia. 5915.3 A person who has been denied a certificate, denied a license, disciplined, convicted of an offense that bears directly upon his or her fitness to be licensed, or who has such an action pending in the District of Columbia or another jurisdiction shall not practice pursuant to this section unless first authorized by the Board in writing. 5915.4 Within five (5) business days after the application for certification has been received by the Board s staff, the Board s staff shall, at the request of the applicant, issue a supervised practice letter to the applicant to document that his or her application is pending and that he or she is authorized to practice under the Act and this chapter. The practice letter is not renewable and shall expire: (a) Ninety (90) days from the date of issuance; (b) Upon receipt of written notice to the applicant of denial of certification; (c) Upon receipt of notice to the application that the applicant has failed the certification examination; or (d) Upon receipt of written notice to the applicant from the Board that the application for certification has been denied, whichever date is the earliest. 5915.5 Upon receipt of the practice letter, the graduate shall inform employers of the date of expiration of the letter and shall immediately cease as a nurse practitioner on that date or upon receipt of the written notice as set forth in 5915.4, whichever date is the earliest. The graduate thereafter may practice in any other area for which the graduate is qualified and licensed in the District, until receipt of a certificate to practice as a nurse practitioner in the District. 5915.6 The graduate shall immediately notify the Board and the graduate s supervisor of the results of the certification examination.

5915.7 Only a nurse practitioner certified under the Act, who is a supervisor, shall be authorized to supervise practice as a nurse practitioner by a graduate. 5915.8 A supervisor shall not supervise more than two (2) graduates at one time. 5915.9 All supervised practice of a graduate shall take place under general or immediate supervision. 5915.10 A graduate who practices pursuant to this section shall only practice at a hospital, long-term care facility, a health facility operated by the District or federal government, or other health care facility considered appropriate and approved by the Board. 5915.11 A graduate practicing under this section shall not assume administrative or technical responsibility for the operation of a nurse practitioner program, unit, service, or institution. 5915.12 A graduate shall identify himself or herself as such before practicing as a nurse practitioner. A graduate shall wear a picture identification badge with lettering clearly visible to the client bearing the name of the graduate and the position title. 5915.13 A graduate shall not receive compensation of any nature, directly or indirectly, from a client or client s family member, except for a salary based on hours worked under supervision. 5915.14 The supervisor shall be fully responsible for the practice by a graduate during the period of supervision and may be subject to disciplinary action for violations of the Act or this chapter by the graduate. 5915.15 The Board may deny an application for a certificate by, or take other disciplinary action against, a graduate who is found to have violated the Act or this chapter. The Board may, in addition to any other disciplinary actions permitted by the Act, revoke, suspend, or restrict the privilege of the graduate to practice. 5916 SUPERVISED PRACTICE OF APPLICANTS FOR CERTIFICATION BY ENDORSEMENT 5916.1 An applicant may practice as a nurse practitioner only in accordance with the Act and this chapter. 5916.2 An applicant for certification by endorsement shall be authorized to engage in the supervised practice as a nurse practitioner in the District of Columbia without a District of Columbia certificate if the applicant: (a) Is currently certified by the ANCC or a certifying body approved by the Board;

(b) Is currently licensed, in good standing, under the laws of a state or territory of the United States; and (c) Has an initial application pending for certification by endorsement to practice as a nurse practitioner in the District of Columbia. 5916.3 A person who has been denied a certificate, denied a license, disciplined, convicted of an offense that bears directly upon his or her fitness to be licensed, or who has such an action pending in the District of Columbia or another jurisdiction shall not practice pursuant to this section unless first authorized by the Board in writing. 5916.4 Within five (5) business days after the application for certification by endorsement has been received by the Board s staff, the Board s staff shall issue a practice letter to the applicant to document that his or her application is pending and that he or she is eligible to practice under the Act and this chapter. The practice letter is not renewable and shall expire: (a) Ninety (90) days from the date of issuance; or (b) Upon receipt of written notice from the Board that the application for certification has been denied, whichever date is the earliest. 5916.5 Upon receipt of the practice letter, the applicant shall inform employers of the date of expiration of the letter and shall immediately cease the practice as a nurse practitioner. The applicant thereafter may practice in any other area for which the graduate is qualified and licensed in the District, until receipt of a certificate to practice as a nurse practitioner in the District. 5916.6 Only a nurse practitioner under the Act, who is a supervisor, shall be authorized to supervise the practice as a nurse practitioner by an applicant. 5916.7 A supervisor shall not supervise more than two (2) applicants at one time. 5916.8 All supervised practice of an applicant shall take place under general or immediate supervision. 5916.9 An applicant who practices pursuant to this section shall only practice at a hospital, long-term facility, a health facility operated by the District or federal government, or other health care facility considered appropriate by the Board. 5916.10 An applicant under this section shall not assume administrative or technical responsibility for the operation of a nurse practitioner program, unit, service, or institution.

5916.11 An applicant shall not receive compensation of any nature, directly or indirectly, from a client or client s family member, except for a salary based on hours worked under supervision. 5916.12 The supervisor shall be fully responsible for the practice by an applicant during the period of supervision and may be subject to disciplinary action for violations of the Act or this chapter by the applicant. 5916.13 The Board may deny an application for a certificate by, or take other disciplinary action against, an applicant who is found to have violated the Act or this chapter. The Board may, in addition to any other disciplinary actions permitted by the Act, revoke, suspend, or restrict the privilege of the applicant to practice. 5999 DEFINITIONS 5999.1 For purposes of this chapter, the following terms have the meanings ascribed: Act- Health Occupation Revision Act of 1985 ( Act ), effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code 3-1201.01 et seq.). Applicant: a person applying for a license to practice as a nurse-practitioner under this chapter. Board: the Board of Nursing, established by 204 of the Act, D.C. Official Code 3-1202.04. Certificate: a certificate to practice as a nurse practitioner under this chapter. Certified nurse practitioner: a registered nurse trained in an educational program and certified by a recognized national certification organization to provide healthcare services who, when functioning within the authorized scope of practice, is qualified to assume primary responsibility for the care of patients. Clinical practice: the routine application of the principles of a nurse practitioner to the diagnosis and treatment of disease and the maintenance of health. Graduate- an individual who has graduated from a post-basic nursing education program for preparation to practice as a nurse practitioner. Supervisor a registered nurse practitioner certified under the Act who is responsible for the supervision of a student, graduate, or applicant. The definitions in 4099 of chapter 40 of this title are incorporated by reference into and are applicable to this chapter.